Purpose: We identified the risk factors for remnant gastric cancer (RGC) based on remnant gastric mucosal characteristics and gastritis morphology in patients undergoing distal gastrectomy. Materials and Methods: This multicenter retrospective study included 100 patients with RGC after distal gastrectomy and 550 patients without RGC treated between 2013 and 2020.Endoscopic findings, including anastomotic redness, red streaks, enlarged folds, bile reflux as anastomotic findings, as well as disappearance of the regular arrangement of collecting venules (RAC), atrophic gastritis, and intestinal metaplasia as background gastric mucosal findings, were evaluated. Disease risk score matching (1:1) was adjusted for baseline characteristics. Logistic regression analysis was used to develop a risk score model to stratify RGC risk into low, moderate, and high categories. Results: After matching, 96 patients with RGC and 96 controls were analyzed. Anastomotic redness and red streaks, as well as the disappearance of RAC and atrophic gastritis, were significantly more frequent in the RGC group than in the control group, whereas enlarged folds and bile reflux showed no significant differences. Risk scores were assigned as follows:anastomotic redness, 2; red streaks, 3; disappearance of RAC, 7; and atrophic gastritis, 3. The total score stratified patients into high (≥15), moderate (7–14), and low risk (≤6). The positive and negative predictive values were 67.7% and 83.3%, respectively. Conclusions The endoscopic findings of anastomotic redness, red streaks, RAC disappearance, and atrophic gastritis were significantly associated with RGC development.The proposed risk-scoring model could serve as a stratification tool for RGC surveillance.

Primary cardiac fibroelastoma is a relatively rare tumor and is often detected incidentally by echocardiography. We report a case of multiple fibroelastomas that were found incidentally by follow-up echocardiography for hypertrophic cardiomyopathy and were treated with valve-sparing excision. The patient was a 71-year-old man, in whom a 10-mm tumor on the ventricular septum below the right coronary cusp and 3-mm tumors on the left ventricular side of the left and right coronary cusps were detected. Although he had no symptoms, because the tumors were mobile, surgery was performed for preventing embolization and making a definitive diagnosis. The tumor on the ventricular septum was excised together with the surrounding endocardium and part of the myocardium. The tumors on the valve leaflets were excised with the aortic valve cusps spared. Histopathologically, all the tumors were fibroelastomas. The postoperative course was uneventful.

A 53-year-old woman with atrial septal defect (ASD) and atrial fibrillation (AF) with idiopathic thrombocytopenic purpura (ITP), was scheduled to undergo ASD closure and the maze procedure. Because steroid therapy was not effective, high-dose γ-globulin administration (400mg/kg/day) was performed for 5 days before surgery. The platelet count increased from 5.4×10⁴/mm³ to 14.0×1⁴/mm³. ASD patch closure and modified bilateral appendage preserving (BAP) maze procedure were performed. No hemorrhagic tendency was recognized. The postoperative course was uneventful, and the sinus rhythm was recovered. The maze procedure become possible in this ITP patient with preoperative administration of high-dose γ-globulin.

The effects of Red Ginseng on osteopenia were investigated in ovariectomized rats. Eight-week-old female Wistar rats were used. Sham operating and ovariectomized control (OVX Cont) rats were given the vehicle. Korean Red Ginseng extract powder (0.1g/kg/day p. o.) was administered to another ovariectomized group (OVX RG). After 12 weeks, blood was drawn, and jejunum and tibia were removed. Histologial parameters in bone and intestinal villi were measured. Biochemical and endocrinological parameters were also measured. Although ovariectomy significantly increased body weight of rats, there was no significant difference between OVX Cont and OVX RG in body weight gain. Bone volume in OVX Cont was significantly lower than in sham operating rats. Administration of Red Ginseng significantly increased the bone volume of tibia in ovariectomized rats. Intestinal villous height in OVX Cont was significantly lower than in sham operating rats. There was a tendency towards increasing intestinal villous height in OVX RG. Administration of Red Ginseng significantly decreased the frequencies of abnormally shaped villi in ovariectomized rats. This experimental study showed that Red Ginseng was effective in inhibiting osteopenia in ovariectomized rats, and it appears that the effect on bone is related to that on intestinal villi.

The effects of Rikkunshi-to (Liu jun zi tang), Hochu-ekki-to (Bu zhong yi qi tang), and Hange-shashin-to (Ban xia xie xin tang) on morphological changes in the small intestinal mucosa of mice with age were observed. The results indicated that Rikkunshi-to and Hochu-ekki-to had a beneficial effect on intestinal mucosal changes in 36-weeks-old mice. In particular, the improvement of the absorptive area of the intestinal villi and microvilli depending on the concentration of medicine was found. Ninjin-yoei-to had a strong effect on aged mice of 50 and 70 weeks. The morphology and absorptive function were significantly improved.

We performed a retrospective study of the effects of steroids and the factors that deteriorate renal function in 30 patients with primary focal segmental glomerular sclerosis. The mean observation periods from the onset of proteinuria and from the histological diagnosis by renal biopsy were 6.1 ± 5.0 years and 3.9 ± 3.01 respectively. 87% of the patients had been recerving steroid therapy with or without other drugs. In this study, the patients were divided into 3 groups by the initial dose of steroids. A multivariate analysis was performed on the laboratory findings of the 3 groups. In a short-term observation, there were no significant defferences among the groups. However, in a long-term observation (more than one year) it was clarified that the patients who had been given high doses of steroids tend to maintain their renal functoin. We also found that the patients responding to steroids showed a significantly better prognosis than steroid-resistant patients upon examination their nephrotic status and renal functoin.
This statistical analysis confirmed that the factors deteriorating the renal function are hypertension and hyperlipidemia.
In addition, it was revealed that hyperuricemia, is responsible for the renal dissease, failure?

The pain eliminating effects of electroacupuncture have long been known however the analgesic mechanism involved has yet to be clarified. Recently with the discovery of endogenous analgesic peptids called endorphins much attention has been called to the relationship of these endorphins and the acupuncture analgesic effect. We examined to determine how electroacupuncture influences lumbar CSF endorphins and the so-called pain transmitting substance, Substance P.
In order to establish continuous lumbar anesthesia using tetracaine for 8 patients with gynecological lower abdominal diseases, a Tuohy needle was inserted from the lumbar area and a catheter inserted into the subarachnoidal space. In each case at the time of the insertion of the catheter 5ml. CSF was tapped. As pre-medication 0.01mg/kg. atropine sulfate, 2mg/kg secobarbiturate were administered. To maintain the analgesic effect hyperbaric or hypobaric tetracaine was administered according to individaul needs. For hypotension during the operations a plasma expander and when necessary ephedrine were administered by intramuscular or intravenous injection.
Immediately following the start of surgery acupuncture needles were inserted at right and left LI-4 and electrical stimulation at 3c/s, 1.0mA was administered for 50-120 minutes using the acupuncture therapy apparatus “TOKKI”. when the operation was finished, after 5ml. of CSF was again tapped through the catheter, the catheter was withdrawn as far as the subdural space and 20-40ml. physiological saline injected to combat the headache due to spinal fluid leakage. The test substance was immediately transferred to a siliconized test tube and cooled to a temperature of-80°C.
The RIA methods were used for the measurement of both endorphins and substance P. The crossover reaction between the β-endorphin and the βLPH was 50%. (Using the β-endorphin measuring kit manufactured by NEN).
The results in 7 of 8 examples showed a significant increase in CSF endorphins after electroacupuncture. It also became clear that there was a tendency for substance P levels to decrease due to electroacupuncture.